Date Presented 04/04/19
A single subject design was used to explore in-seat time changes in a child with sensory-craving behaviors following participation in a 12-week enhanced sensory program (ESP) in OT. The ESP included occupation-based vestibular, tactile, and proprioceptive stimulation provided through play. Findings suggest that time in-seat was more stable on days when the ESP was provided, as compared to days when the program was not provided. More data are needed to validate these findings.
Primary Author and Speaker: Kerrie Ramsdell
Additional Authors and Speakers: Barbara Doucet
PURPOSE: To investigate the effects of a 12-week enhanced sensory program (ESP) on increasing the in-seat time of a child with sensory craving behaviors during mealtimes at home.
DESIGN: A single-subject design was used to collect and report data.
METHOD: Therapists at a private practice collaborated with the STAR Institute for Sensory Processing Disorder (SPD) (Star Institute, 2018), a research and treatment center for adults and children with SPD to design and implement this research project. Treatment consent was obtained from the parents of a 5½-year-old male with sensory craving behaviors for participation. ESP was provided by occupational therapists at the facility 2X/week through 45-minute sessions over the course of 12 weeks. In a prior research project, treatment fidelity was established for the ESP being used for intervention. Mother filmed child on 26 occasions at home during mealtime. Investigators reviewed videotapes and recorded times when the child was in-seat and eating. Times were calculated for each video and results were graphically charted to examine trend over time.
RESULTS: Average time spent in seat at mealtimes across all 26 recordings was shown to be variable, at 7.28 ± 5.97 minutes. Further analysis revealed that when time in seat on days of therapy was calculated and linearly graphed separately from time in seat on non-therapy days, a distinct difference was seen. Over the 12 weeks of intervention, when times were graphically plotted, a downward negative trendline was apparent (R2 = 0.49) on the non-therapy days suggesting less time in seat over this period. In contrast, linear graphical analysis showed more stability for in-seat time on therapy days with a trendline approaching a slope of 0 (R2 = 0.01).
CONCLUSION: The results of this single-subject design investigating the effects of an ESP in a child with sensory craving behaviors indicated that average time in seat was highly variable when calculated over the 12-week intervention period. However, further analysis begins to suggest that time in seat for mealtimes showed stability and consistency on days when the child participated in the ESP as compared to days when he did not. Data collection is ongoing with this project, and we anticipate having additional participants and data by the 2019 Conference date.
IMPACT STATEMENT: ESPs for children with sensory craving behaviors delivered systematically and with treatment fidelity may improve outcomes in occupational performance. More empirical data are needed from clinicians to validate and expand on these preliminary findings and to increase third party payment of sensory interventions.
References
May-Benson, T. A., & Koomar, J. A. (2010). Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. American Journal of Occupational Therapy, 64(3), 403–414. doi:10.5014/ajot.2010.09071
American Occupational Therapy Association [AOTA]. (2017). Pediatric reimbursement FAQs. Retrieved from https://www.aota.org/Advocacy-Policy/Federal-Reg-Affairs/Pay/Schools/Pediatric.aspx
STAR Institute for Sensory Processing Disorder, https://www.spdstar.org
